<div class="modal-body wrapper-lg">
  <!-- Modal -->

  <div class="wrapper-md">
    <form class="form-horizontal">
      <div class="panel panel-default">
        <div class="panel-heading"><strong>收费项目信息输入</strong></div>
        <div class="panel-body">

          <div class="col-lg-4 col-sm-6">
            <div class="form-group">
              <label class="col-sm-5 control-label nowrap">收费名称:</label>
              <div class="col-sm-7">
                <input type="text" class="form-control" placeholder="">
              </div>
            </div>
          </div>

          <div class="col-lg-4 col-sm-6">
            <div class="form-group">
              <label class="col-sm-5 control-label nowrap">收费类型:</label>
              <div class="col-sm-7">
                <select class="form-control">
                  <option value="">周期收费</option>
                  <option value="">按建筑面积周期收费</option>
                  <option value="">按套内面积周期收费</option>
                </select>
              </div>
            </div>
          </div>

          <div class="col-lg-4 col-sm-6">
            <div class="form-group">
              <label class="col-sm-5 control-label nowrap">周期:</label>
              <div class="col-sm-7">
                <select class="form-control">
                  <option value="">年</option>
                  <option value="">季</option>
                  <option value="">月</option>
                </select>
              </div>
            </div>
          </div>

          <div class="col-lg-4 col-sm-6">
            <div class="form-group">
              <label class="col-sm-5 control-label nowrap">计费单位:</label>
              <div class="col-sm-7">
                <select class="form-control">
                  <option value="">平方米</option>
                  <option value="">户</option>
                  <option value="">顿</option>
                </select>
              </div>
            </div>
          </div>

        </div>
      </div>

      <div class="panel panel-default">
        <div class="panel-body">

          <div class="col-sm-6">
            <div class="row">
              <div class="col-sm-4">
                <div class="form-group">
                  <label class="col-sm-5 control-label nowrap">关联项:</label>
                  <div class="col-sm-7">
                    <select class="form-control">
                      <option value="">无</option>
                      <option value="">房屋</option>
                      <option value="">车位</option>
                    </select>
                  </div>
                </div>
              </div>
              <div class="col-sm-8">
                <div class="form-group">
                  <label class="col-sm-5 control-label nowrap">关联类型:</label>
                  <div class="col-sm-7 form-inline">
                    <label class="i-checks radio"><input type="radio" /><i></i> 数值型</label>
                    <label class="i-checks radio"><input type="radio" /><i></i> 时间型</label>
                  </div>
                </div>
              </div>
            </div>
          </div>

          <div class="col-sm-6">
            <div class="form-group">
              <label class="col-sm-5 control-label nowrap">适用功能范围:</label>
              <div class="col-sm-7 form-inline">
                <label class="i-checks checkbox"><input type="checkbox" /><i></i> 收费计划</label>
                <label class="i-checks checkbox"><input type="checkbox" /><i></i> 退费申请</label>
                <label class="i-checks checkbox"><input type="checkbox" /><i></i> 费用调整申请-定向优惠</label>
              </div>
            </div>
          </div>

        </div>
        <div class="panel-footer form-line">
          适用类型：
          <label class="i-checks checkbox"><input type="checkbox" /><i></i> 私有</label>
          <label class="i-checks checkbox"><input type="checkbox" /><i></i> 租赁合约</label>
        </div>

      </div>

      <div class="panel">
        <div class="panel-body">

          <div class="row">
            <div class="form-group">
              <div class="col-sm-2">
                <label class="col-sm-5 control-label nowrap">计价类型:</label>
              </div>
              <div class="col-sm-5">
                <select class="form-control">
                  <option value="">默认计价</option>
                  <option value="">公式计价</option>
                </select>
              </div>
              <div class="col-sm-5 form-inline">
                基数：
                <select class="form-control" style="width: 80px;">
                  <option value="">+</option>
                  <option value="">-</option>
                </select>
                <input type="number" class="form-control" style="width: 80px;" />
              </div>
            </div>
          </div>

          <div class="row">
            <div class="form-group">
              <div class="col-sm-2">
                <label class="col-sm-5 control-label nowrap">公式计价:</label>
              </div>
              <div class="col-sm-5">
                <div class="row">
                  <div class="col-sm-2"> <label class="col-sm-5 control-label nowrap">变量：</label></div>
                  <div class="col-sm-4">
                    <select class="form-control" style="width: 120px;">
                      <option value="">楼层</option>
                    </select>

                    <select class="form-control" style="width: 60px;">
                      <option value="">></option>
                    </select>
                  </div>
                  <div class="col-sm-3">
                    <input type="text" class="form-control" style="width: 60px;" />
                    <label class="i-checks"><input type="checkbox" />(含)</label>
                  </div>
                  <div class="col-sm-3">
                    递增量：<input type="text" class="form-control" style="width: 60px;" />
                  </div>
                </div>

              </div>
              <div class="col-sm-5 form-inline">
                基数：
                <select class="form-control" style="width: 80px;">
                  <option value="">+</option>
                  <option value="">-</option>
                </select>
                <input type="number" class="form-control" style="width: 80px;" />
              </div>
            </div>
          </div>

        </div>
      </div>

      <div class="panel">
        <div class="panel-heading">阶梯计价</div>
        <div class="panel-body">
          <div class="col-sm-4">
            <div class="form-group">
              <label class="col-sm-5 control-label nowrap">阶梯计价:</label>
              <div class="col-sm-7">
                <input type="text" class="form-control" />
              </div>
            </div>
          </div>
          <div class="col-sm-8">
            <div class="form-group">
              <label class="col-sm-5 control-label nowrap">阶梯单位:</label>
              <div class="col-sm-7">
                <input type="text" class="form-control" />
              </div>
            </div>
          </div>
        </div>
      </div>

      <div class="panel">
        <div class="panel-heading">分段计价</div>
        <div class="panel-body">
          <div class="row">
            <div class="col-sm-4">
              <div class="form-group">
                <label class="col-sm-5 control-label nowrap">变量:</label>
                <div class="col-sm-7">
                  <select class="form-control">
                    <option value="">楼层</option>
                    <option value="">楼层</option>
                    <option value="">楼层</option>
                  </select>
                </div>
              </div>
            </div>
          </div>
          <div class="row">
            <div class="col-sm-4">
              <div class="form-group">
                <label class="col-sm-5 control-label nowrap">变量分段:</label>
                <div class="col-sm-7">
                  <input type="text" class="form-control" />
                </div>
              </div>
            </div>
            <div class="col-sm-8">
              <div class="form-group">
                <label class="col-sm-5 control-label nowrap">分段单位:</label>
                <div class="col-sm-7">
                  <input type="text" class="form-control" />
                </div>
              </div>
            </div>
          </div>
        </div>
      </div>

      <div class="panel">
        <div class="panel-heading">对应值计价</div>
        <div class="panel-body">
          <div class="row">
            <div class="col-sm-4">
              <div class="form-group">
                <label class="col-sm-5 control-label nowrap">变量:</label>
                <div class="col-sm-7">
                  <select class="form-control">
                    <option value="">楼层</option>
                    <option value="">楼层</option>
                    <option value="">楼层</option>
                  </select>
                </div>
              </div>
            </div>
          </div>
          <div class="row">
            <div class="col-sm-4">
              <div class="form-group">
                <label class="col-sm-5 control-label nowrap">变量队列:</label>
                <div class="col-sm-7">
                  <input type="text" class="form-control" />
                </div>
              </div>
            </div>
            <div class="col-sm-8">
              <div class="form-group">
                <label class="col-sm-5 control-label nowrap">对应单价:</label>
                <div class="col-sm-7">
                  <input type="text" class="form-control" />
                </div>
              </div>
            </div>
          </div>
        </div>
      </div>

      <div class="panel">
        <div class="panel-body">
          <div class="col-lg-4 col-sm-6">
            <div class="form-group">
              <label class="col-sm-5 control-label nowrap">收费范围:</label>
              <div class="col-sm-7">
                <div class="row">
                  <div class="col-sm-5"><input type="text" name="" class="form-control"></div>
                  <div class="col-sm-1">-</div>
                  <div class="col-sm-5"><input type="text" name="" class="form-control"></div>
                </div>
              </div>
            </div>
          </div>
        </div>
      </div>

      <div class="panel">
        <div class="panel-heading">其他设置</div>
        <div class="panel-body">
          <div class="col-lg-4 col-sm-6">
            <div class="form-group">
              <label class="col-sm-5 control-label nowrap">允许抹零:</label>
              <div class="col-sm-7">
                <label class="i-checks"><input type="checkbox" />是</label>
                <label class="i-checks"><input type="checkbox" />否</label>
              </div>
            </div>
          </div>
          <div class="col-lg-4 col-sm-6">
            <div class="form-group">
              <label class="col-sm-5 control-label nowrap">启用状态:</label>
              <div class="col-sm-7">
                <label class="i-checks"><input type="checkbox" /> 启用</label>
                <label class="i-checks"><input type="checkbox" /> 停用</label>
              </div>
            </div>
          </div>
        </div>
      </div>

      <div class="panel">
        <div class="panel-body">
          <div class="col-lg-4 col-sm-6">
            <div class="form-group">
              <label class="col-sm-5 control-label nowrap">有效开始日:</label>
              <div class="col-sm-7">
                <input type="date" class="form-control" />
              </div>
            </div>
          </div>
          <div class="col-lg-4 col-sm-6">
            <div class="form-group">
              <label class="col-sm-5 control-label nowrap">有效截止日:</label>
              <div class="col-sm-7">
                <input type="date" class="form-control" />
              </div>
            </div>
          </div>
        </div>
      </div>

      <div class="panel">
        <div class="panel-heading">收费范围</div>
        <div class="panel-body">
          <div class="col-md-6">
            <div class="panel">
              <div class="panel-heading">收费范围</div>
              <div class="panel-body">
                <div class="col-md-6">

                </div>
                <div class="col-md-6">
                  <p>快速检索</p>
                  <table class="table table-bordered">
                    <thead>
                      <tr>
                        <td>区域</td>
                        <td>数量</td>
                        <td>范围</td>
                        <td>管家</td>
                      </tr>
                    </thead>
                    <tbody>
                      <tr>
                        <td>
                          <label class="i-checks"><input type="checkbox" /><i></i> A</label>
                        </td>
                        <td>212</td>
                        <td>1号楼</td>
                        <td>马良</td>
                      </tr>
                      <tr>
                        <td>
                          <label class="i-checks"><input type="checkbox" /><i></i> A</label>
                        </td>
                        <td>212</td>
                        <td>1号楼</td>
                        <td>马良</td>
                      </tr>
                      <tr>
                        <td>
                          <label class="i-checks"><input type="checkbox" /><i></i> A</label>
                        </td>
                        <td>212</td>
                        <td>1号楼</td>
                        <td>马良</td>
                      </tr>
                    </tbody>
                  </table>
                </div>
              </div>
            </div>
          </div>

          <div class="col-md-6">
            <div class="panel">
              <div class="panel-heading">车位范围</div>
              <div class="panel-body">
                <div class="col-md-6">

                </div>
                <div class="col-md-6">
                  <p>快速检索</p>
                  <table class="table table-bordered">
                    <thead>
                      <tr>
                        <td>区域</td>
                        <td>数量</td>
                        <td>范围</td>
                        <td>管家</td>
                      </tr>
                    </thead>
                    <tbody>
                      <tr>
                        <td>
                          <label class="i-checks"><input type="checkbox" /><i></i> A</label>
                        </td>
                        <td>212</td>
                        <td>DSA001-DSA300</td>
                        <td>马良</td>
                      </tr>
                      <tr>
                        <td>
                          <label class="i-checks"><input type="checkbox" /><i></i> A</label>
                        </td>
                        <td>212</td>
                        <td>DSA001-DSA300</td>
                        <td>马良</td>
                      </tr>
                      <tr>
                        <td>
                          <label class="i-checks"><input type="checkbox" /><i></i> A</label>
                        </td>
                        <td>212</td>
                        <td>DSA001-DSA300</td>
                        <td>马良</td>
                      </tr>
                    </tbody>
                  </table>
                </div>
              </div>
            </div>
          </div>

          <div class="col-md-6">
            <div class="panel">
              <div class="panel-heading">合约范围</div>
              <div class="panel-body">

                <table class="table table-bordered">
                  <thead>
                    <tr>
                      <td></td>
                      <td>租金类别</td>
                      <td></td>
                    </tr>
                  </thead>
                  <tbody>
                    <tr>
                      <td>
                        <label class="i-checks"><input type="checkbox" /><i></i></label>
                      </td>
                      <td>2</td>
                      <td></td>
                    </tr>
                    <tr>
                      <td>
                        <label class="i-checks"><input type="checkbox" /><i></i></label>
                      </td>
                      <td>2</td>
                      <td></td>
                    </tr>
                    <tr>
                      <td>
                        <label class="i-checks"><input type="checkbox" /><i></i></label>
                      </td>
                      <td>2</td>
                      <td></td>
                    </tr>
                  </tbody>
                </table>
              </div>
            </div>
          </div>
        </div>
      </div>

      <div class="panel panel-default">
        <div class="panel-body">
          <div class="form-group">
            <label class="col-md-12"><p>说明:</p></label>
            <div class="col-md-12">
              <textarea class="form-control" rows="6" placeholder=""></textarea>
            </div>
          </div>
        </div>
      </div>

      <div class="m-t text-center">
        <button class="btn btn-success">确定</button>

        <button class="btn btn-info">修改</button>

        <button class="btn btn-danger">删除</button>

        <button class="btn btn-info">返回</button>
      </div>

    </form>
  </div>
  <!-- END Modal -->

</div>